HELP-clinicals tomorrow!!

[oneluv]

Hi

Hoping someone can help me....I have to do a supra pubic catheter change tomorrow and I can't find it in my skills book.....anyone?..I know bad idea leaving it for the last minute.

Maybe just a resource that I could look up some info so I'm not totally unprepared. The order just says supra pubic cath change every 2 months w/ 22 french. I'm assuming I'm only changing tubing then.....?

[Reno1978, BSN, RN]

Can you find information for a normal indwelling/foley catheter change in your skills book? It's basically the same thing except the entrance to the bladder is an incision a few inches below the navel rather than the urethra. If it's one of your first catheter changes, they're less stressful since you don't deal with genetalia, so insertion is rather easy.

[Dolce, RN]

Suprapubic catheters are very easy to change. You will need a foley cath insertion tray and the correct size of catheter. Remove the old catheter using non sterile gloves. Assess the stoma. Is there any excoriation? Do you note a foul smell? Is there drainage? Next, open your foley catheter kit and drop your new foley catheter (correct size) onto your sterile field. Don sterile gloves. Check the foley catheter with the syringe to ensure that it inflates properly. Now prep the site with betadine--using all three sticks or soaked cotton swabs cleanse around the stoma in a circular fashion. After the betadine has dried you may dip the catheter tip in your sterile lube and prepare to insert the catheter. Pushing straight into the abdomen advance the catheter slowly but firmly. You may feel it "pop" into the bladder and you will get a urine return. Advance slightly more and inflate the balloon. Voila'! You are done! :)

[oneluv]

Thank you

Interesting enough we did go over how to insert a catheter, but not for one in a stoma...this is very helpful...

[oneluv]

Thank you .....I do have that information.

[harley007]

Just remember not to insert the catheter too far as it can exit the bladder especially in a male pt. We usualy used a 4" average insertion length. I worked a shift following a routine S/P cath change and the pt. was in severe pain and bleeding from the member. Previous nurse had inserted the cath. all the way to the Y and inflated the 30cc balloon tip in his member. She performformed a rather crude and accidental TURP on the poor guy. The prodceedure above is perfect just watch how far you insert and good luck to you, I sure you be great!

[Dolce, RN]

Just remember not to insert the catheter too far as it can exit the bladder especially in a male pt. We usualy used a 4" average insertion length. I worked a shift following a routine S/P cath change and the pt. was in severe pain and bleeding from the member. Previous nurse had inserted the cath. all the way to the Y and inflated the 30cc balloon tip in his member. She performformed a rather crude and accidental TURP on the poor guy. The prodceedure above is perfect just watch how far you insert and good luck to you, I sure you be great!

OUCH!!

One time I inserted a SP catheter too far on a woman and it ended up in her lady parts!!!! Apparently my catheter found a fistula.... I've learned since then to not insert the catheter so far, even if I'm not getting urine return. The bladder is right there, there is no need to push the catheter in so far.

[ne29]

Suprapubic catheters are very easy to change. You will need a foley cath insertion tray and the correct size of catheter. Remove the old catheter using non sterile gloves. Assess the stoma. Is there any excoriation? Do you note a foul smell? Is there drainage? Next, open your foley catheter kit and drop your new foley catheter (correct size) onto your sterile field. Don sterile gloves. Check the foley catheter with the syringe to ensure that it inflates properly. Now prep the site with betadine--using all three sticks or soaked cotton swabs cleanse around the stoma in a circular fashion. After the betadine has dried you may dip the catheter tip in your sterile lube and prepare to insert the catheter. Pushing straight into the abdomen advance the catheter slowly but firmly. You may feel it "pop" into the bladder and you will get a urine return. Advance slightly more and inflate the balloon. Voila'! You are done! :)

I have a quick question that may sound silly but if the sterile gloves come out of the foley catheter kit why can't they be opened over the kit instead of moving them to another spot to put them on????

I always wanted to know that.

Nicole

[karendc21]

wow! I'm learning a lot from here... thanks for those informations...